In a new editorial, two infectious disease specialists say the international response to the Ebola outbreak has been vastly inadequate, resulting in the unnecessary deaths of hundreds of people. A scaled up response could reduce the mortality rate by more than half, they say.
The world’s “disastrously inadequate response” to West Africa’s Ebola outbreak means many people are dying who could easily be saved, the head of the World Bank said on Monday, as Nigeria confirmed another case of the highly contagious virus.
In a Washington Post editorial, World Bank President Jim Yong Kim said Western healthcare facilities would easily be able to contain the disease, and he urged wealthy nations to share knowledge and resources to help African countries tackle it.
“The crisis we are watching unfold derives less from the virus itself and more from deadly and misinformed biases that have led to a disastrously inadequate response to the outbreak,” Kim wrote in the Washington Post.
“Many are dying needlessly,” read the editorial, co-written by Harvard University professor Paul Farmer with whom Kim founded Partners In Health, a charity organization that works for better healthcare in poorer countries.
Ebola is transmitted through direct contact with the bodily fluids (e.g., blood, urine, feces, vomit) of an infected person. There is no known cure, though work on experimental vaccines has been accelerated.
Rigorous infection control measures are required to contain the virus, which has spread uncontrollably among health care workers and informal caregivers (usually female family members) in the current outbreak. However, as Drs. Kim and Farmer point out, if the Ebola outbreak in West Africa “had instead struck Washington, New York or Boston, there is no doubt that the health systems in place could contain and then eliminate the disease.” They continue, explaining:
Hospitals would isolate suspected cases. Health workers would be outfitted with proper protective clothing and equipment. Doctors and nurses would administer effective supportive care, including comprehensive management of dehydration, impaired kidney and liver function, bleeding disorders and electrolyte disturbance. Labs would dispose of hazardous materials properly. And a public health command center would both direct the response and communicate clearly to the public about the outbreak.
A functioning health system can stop Ebola transmission and, we believe, save the lives of a majority of those who are afflicted.
But that’s not what has happened in West Africa.
Nearly 1,600 people have been killed in the worst outbreak of the disease since it was discovered in 1976 near the Ebola river in what is now the Democratic Republic of Congo. More than 3,000 people, mostly in Sierra Leone, Guinea and Liberia have been infected, and the outbreak appears to be picking up pace: According to the World Health Organization (WHO), more new cases were reported last week than during any other week since the outbreak began. Nearly 40 percent of the total number of reported cases have occurred within the past three weeks.
‘Tens of thousands of lives… hang in the balance’
Poor healthcare provision h..as exacerbated the challenge of containing the outbreak. Liberia had just 50 doctors for its 4.3 million people before the outbreak, and many medical workers have died of Ebola. Fear of contracting the virus has even led some doctors in the area to simply close their clinics and stop providing healthcare.
Shortages of basic goods — including food and water — and medical equipment have been worsened by the decision of many airlines to stop flying to the worst hit countries. Several neighboring states have closed their borders and many international organizations have pulled their foreign staff, creating a humanitarian crisis that rivals the outbreak in its severity.
The World Health Organization has launched a $490 million plan to contain the epidemic, with the goal of stopping ongoing Ebola transmission worldwide within 6–9 months, while also managing the consequences of any further international spread. They warned last week that casualty figures could be up to four times higher than reported and said up to 20,000 people may be infected with the virus before the outbreak can be contained.
In the new editorial, Drs. Kim and Farmer said that if international organizations and wealthy nations mounted a coordinated response with West African nations using the WHO plan, the fatality rate could drop to below 20 percent – from 50 percent now.
“We are at a dangerous moment,” they wrote. “Tens of thousands of lives, the future of the region and hard-won economic and health gains for millions hang in the balance.”
‘International response is slow and derisory’
Nigeria confirmed a third case of Ebola on Monday in the oil hub of Port Harcourt, bringing the total confirmed infections nationwide to 16, with around 200 people under surveillance.
A doctor in Port Harcourt died last week after treating a contact of the Liberian-American man who was the first recorded case of the virus in Africa’s most populous country. That raised alarm that Ebola, which looked on the verge of being contained in the commercial capital, Lagos, may flare up elsewhere.
Senegal, a transport hub and center for aid agencies, became the fifth African nation to confirm a case of Ebola on Friday, a 21-year-old Guinean student who had evaded surveillance in his homeland and arrived in Dakar.
“People should know that if it were not for this boy’s state of health, he would be before the courts,” President Macky Sall told state television. “You cannot be a carrier of sickness and take it to other countries.”
Some shops in the bustling Senegalese capital ran out of hand sanitizer on Monday as concerned residents stocked up. The house and shop owned by the student’s relatives in the densely populated Dakar neighborhood of Parcelles Assainies was disinfected by health teams. Authorities placed 20 people who had come into contact with the student under surveillance and were giving them twice daily health checks.
Medical charity Medecins Sans Frontieres (MSF) called for the rapid deployment of staff and resources. “The international response is slow and derisory. It can equally be defined as irresponsible,” MSF said.